My Turn: I’m a doctor, and I won’t send my kids back to school without a vaccine

For the Monitor
Published: 6/17/2020 1:24:04 PM

To my local school district: As I write this, I want you to know that I think that you have shown a remarkable understanding of the pandemic and what’s at stake for the students and families. I also want you to know that I think the teachers have done a wonderful job of making remote learning both fun and doable for me and my children.

I have filled out two surveys with regard to my hopes and fears and expectations of schooling in September. And I think the surveys were helpful and thorough, but I want to see if I can help you understand what this pandemic looks like to a doctor and a parent of school-aged children.

To begin with, I want to quote numbers available from the CDC and the medical journals. The overall death rate from COVID-19 is about 100,000 Americans in three months. That is about the same death rate as for cardiovascular disease in this country, except it’s additional deaths of previously ill and previously healthy people. And if we wait, patiently, for a good, reliable COVID-19 vaccine to be approved and to be distributed in the next year, that death rate will drop to almost zero in the vaccinated.

Right now, the overall mortality rate (a.k.a. the death rate) is as high as 15% in some subgroups, but in all comers, the lowest estimated death rate in the United States is 0.4% to 0.8%. Translating that to real numbers, that means for every 1,000 people (adults and children) who get COVID-19 four to eight die. And those numbers are with everyone socially distancing.

If you look at the numbers of deaths before social distancing and masks, the death rates are closer to four to eight people dead for every 100 people ill with COVID. (Here I am quoting numbers from the CDC early contact tracing, where everyone in an exposed group was tested, even the asymptomatic, and everyone who tested positive was considered to truly have the disease.)

Now take those numbers and apply them to a grade K-8 school where, students, teachers, and staff together, approximately 1,000 people attend. I am not willing to risk my children. I do not think anyone should risk becoming one of the dead, even if their chances of dying are only 4 in 1,000. Perhaps you have heard of the newly recognized Kawasaki-like disease associated with COVID-19? This is a deadly disease to children, although (thankfully) it is curable in this country, if it is recognized and treated appropriately.

Let me try one more thing I tell patients when I try to explain COVID disease and its risks.

I ask, “Do you know someone in their seventies or older? Someone who lived through the polio epidemic of 1950s?” Almost everyone can say yes.

Now, I say, “ask that 70-year-plus person if he or she can remember who died or was crippled during in the polio epidemic of the 1950s.” I guarantee you that person will remember. Usually that person says, “Yeah, (so-and-so) got the polio and was permanently crippled or killed by it.”

And then I say, “Actually, you all got polio. And most of you had a mild GI bug, while some of you had a severe GI bug, but the people you remember are the ones who died or who were crippled by it.”

I know the numbers for COVID are not quite the same as the 1950s polio epidemic, but the picture is similar. COVID is a disease where some people have mild symptoms and others have severe symptoms, but “only” a few people die.

But it’s not the 1950s any more. We live in a privileged part of the world where a good, safe, and effective vaccine is going to be available in less than a year. The polio epidemic was ended in the United States by a huge mobilization of Sabin and Salk polio vaccinations for American school children. To me, it’s an obvious conclusion: I am going to wait for the vaccine to become available before I send my children back to school.

In addition, even if school starts in some way in September (with half or a third of the children in school in any one day), there is still no way that I can send my children back to school until there is a vaccine. Because if any one of my children becomes ill with anything, I will be out of work until we determine it’s not COVID. And if it is COVID, and no one dies, then I will be out of work for 14 to 60 days, depending on the level of illness of any one of the three generations of people who live in my house.

Even asymptomatic COVID will keep me home for weeks until I test positive and then negative twice.

So I hope that there will be a remote learning option, with at least as much support as I have had this spring. And even more remote friending for my children to be able to reach their friends through video chats, closed video gaming, texts, and socially distant socialization (like bike riding).

I realize that many of you don’t know anyone personally who has died or been seriously ill from COVID. I assure you, that is because, from March 16 until now, schools have been closed and majority of people have stayed home – in a form of quarantine.

I hope you continue to socially distance, wash hands, and wear masks because COVID spreads in the community via the asymptotic or mildly ill. These things do lower community spread. But to lower community spread so the “curve” goes down (one ill person infecting less than one additional person) then it’s estimated (by scientists who specialize in this) that a majority of people – two-thirds or better – need to cooperate.

I hope you understand why I am counseling patience – to wait and to vaccinate – to my patients.

(Dr. Laura Smith Emmick lives in Manchester.)

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